Provider Demographics
NPI:1821492158
Name:EAST TENNESSEE URGENT CARE
Entity Type:Organization
Organization Name:EAST TENNESSEE URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:TUTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-577-3882
Mailing Address - Street 1:PO BOX 11484
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-1484
Mailing Address - Country:US
Mailing Address - Phone:865-577-3882
Mailing Address - Fax:865-577-3889
Practice Address - Street 1:311 S WEISGARBER RD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-7504
Practice Address - Country:US
Practice Address - Phone:865-577-3882
Practice Address - Fax:865-577-3889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN020952207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty